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Introduction

This is a case study of rehabilitation for a client who underwent the operation of total hip replacement. This operation commonly happened in older population due to some of the following conditions such as Osteoarthritis, Necrosis of femoral head due to fracture neck of femur...etc. This case was developed to assist student to understand more about the various stages of rehabilitation and specific treatment considerations for older adult client who will discharge home after the surgery. You are recommended to try the "quiz" below after you read the Client information.

Client Information

Client data base (obtained from case record and interview)

Name of client: Mrs. Chan

Age/Sex: F/67

Height:130cm

Weight: 60kg

Medical history: Osteoarthritis of right & left hips and right total hip replacement. (click here for further information)

Mrs. Chan has bilateral hip pain for years. Pain is much worse in the right hip, which radiates down to the knee. The advanced osteoarthritis of the right hip progresses to the extent that it disturbs her sleep despite of taking heavy dose of analgesics. She undergoes an elective right total hip replacement with un-cemented prosthesis.

Mrs Chan has no other medical problem in the case record file

Social background:

Client is widowed for 10 years. She lives with her son and his family whom are very supportive. She helps in looking after her grandson (age 10) at home in the daytime. She used to be fairly active in outdoor activities. She enjoys going for morning walks and joining her friends in the nearby community center. She becomes more housebound due to increasing right hip pain starting from half a year ago.

Living environment:

Mrs. Chan and her family live in a 2 bedroom flat in a public housing estate with lift-landing. She shares the bedroom with her grandson. There is a shower cubicle and toilet in the bathroom. The market (muti-storey), teahouse and the community center are within 10 minuteˇ¦s walk from Mrs. Chanˇ¦s home. 

Pre-morbid functional level:

Until half a year ago, Mrs. Chanˇ¦s ADLs & basic IADLs (e.g. laundry, meal preparation, daily shopping) are performed independently, although longer time is needed to accomplish the tasks due to hip pain. She also helps in looking after her grandson.

Present role:

She becomes housebound, and is unable to perform any of the IADL task. She needs to hold onto the furniture to walk. She has severe bilateral hip pain on walking for long distance; managing stairs, going up & down the bus. For outdoor activities, her family usually accompanies her. Sometimes, she carries a walker with her.

There are the 3 stages of Mrs. Chan's rehabilitation process divided as follow:

Acute stage in an acute hospital: 1-2 weeks post-operation;

Rehabilitative stage in an in-patient rehabilitation hospital : 1-5 weeks post-operation for intensive rehabilitation 

Pre-discharge stage in an in-patient rehabilitation hospital: 4-6 weeks post-operation in preparing the patient to return home.

There are some more discussion questions related to Mrs. Chan. You can click here to access directly .

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